A multiple myeloma case accompanying to lung, colon and gastric

A multiple myeloma case accompanying to lung, colon and gastric cancer
Muzaffer Keklik¹, Serdar Sivgin¹, Halit Karaca², Celalettin Eroglu³, Ummuhan Abdulrezzak⁴, Gulsah
Akyol¹, Gulfugan Kuzu⁵, Leylagul Kaynar¹, Ali Unal¹, Bulent Eser¹
¹ Erciyes Stem Cell Transplantation Hospital, Department of Hematology, Faculty of Medicine,
Erciyes University, Kayseri, Turkey
²Department of Medical Oncology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
³ Department of Radiation Oncology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
⁴Department of Nuclear Medicene, Faculty of Medicine, Erciyes University, Kayseri, Turkey
⁵Department of Internal Medicene, Faculty of Medicine, Erciyes University, Kayseri, Turkey
Introduction and Objective: The association of multiple myeloma with solid tumors is rare. A
literature review of 1,104,269 cancer patients concluded that the prevalence of multiple primary cancer
is between 0.73% and 11.7%. In this study, we presented a case diagnosed as multiple myeloma in
addition to colon cancer, gastrointestinal stromal tumor and lung adenocarcinoma association since it
doesn’t exist in the literature. Case: A 67-years old male presented to Gastroenterology Department
with abdominal pain and nausea lasting for 2-3 months. In the colonoscopy, an annular mass was
detected at descending colon, where a biopsy was done. Sigmoid resection, metastasectomy and left
hemicolectomy were performed in the patient who underwent surgery with a diagnosis of colon
adenocarcinoma with liver metastasis. During operation, a mass seen at gastric wall was resected and
reported as gastrointestinal stromal tumor of gastric wall. On the PET CT scan performed 9 months
after completion of chemotherapy, a suspected metastasis at upper lobe of right lung, intraabdominal
lymph nodes, paratracheal lymph nodes, diffuse bone
involvement and involved humeral and femoral diaphysis (bone marrow involvement?) were detected
in the patient who had been followed with stable disease. (Figure 1, 2 and 3). IgG-κ monoclonality
was detected in the patient who had elevated protein levels as well as hypoalbuminemia and
hyperalbuminemia. In the bone marrow aspiration, plasma cells (50%) were detected and bone marrow
biopsy result were reported as plasmacytoma. Also, a biopsy was performed to pulmonary lesion,
which was reported as adenocarcinoma. Result: Multiple primary cancer is a specific malignant tumor
type and the precise mechanism has remained unknown. In conclusion, we believe that a consensus
should be reached in investigations evaluating reasons of recurrence, privilege in the treatment of
multiple cancers and prevention of multiple cancers, since the cause of cancer has not been fully
elucidated yet.
Figure 1: Intra-abdominal lymph nodes
Figure 2: Involvement at right upper lobe of lung
Figure 3: Diffuse bone involvement in addition to involved humeral and femoral diaphysis.